Everyone, William Venous of Dialysis Purchasing Alliance has forwarded good news concerning miscalculations in the drug reimbursement by CMS for 2006. If the NRAA-GPO is not working for you, DPA is an alternative dedicated to working on behalf of independent ESRD providers.

"GOOD NEWS, if you have not already received this email.



Dialysis Purchasing Alliance

William Venus

Managing Director

wvenus@dpagpo.com

5500 New Horizons Blvd

N. Amityville, NY 11701

tel: 800-372-4002 x6901

fax: 631-789-6901





-----Original Message-----
From: CMS CMSProviderResource [mailto:CMSProviderResource@CMS.HHS.GOV]
Sent: Thursday, September 01, 2005 4:25 PM
To: ESRD-L@LIST.NIH.GOV
Subject: Correction to the Proposed ESRD Drug Add-on Adjustment Published in the Federal Register, August 8, 2005



Correction to the Proposed ESRD Drug Add-on Adjustment

Published in the Federal Register, August 8, 2005

ESRD industry representatives have brought to our attention an error in the estimation of the market shares for the top ten ESRD drugs that we used in our calculation of the proposed drug add-on adjustment for 2006.

After an analysis of the 2003 expenditure data used to assign weights to the top ten ESRD drugs, we determined that our data did not appropriately account for three �J� code changes that were implemented in 2003. As a result the total expenditures for Iron Sucrose, Sodium Ferric Gluconate, and Calcitriol were understated.

In addition, the weight for EPO incorrectly included expenditures for hospital-based facilities. Since the purpose of the weighting was to allocate the drug spread to all other drugs paid using the proposed ASP+6% pricing, hospital-based data should not have been included because we had proposed to continue paying for other hospital-based facility drugs based on cost. The attached table shows the revised weights compared to the weights included in the proposed rule.

Using these revised weights, the proposed recalculated 2005 drug add-on adjustment should be 10.4 percent, and the proposed 2006 update should be 0.8 percent. The correct total drug add-on adjustment proposed for 2006 is 11.3 percent.

We note that for the final rule we intend to use more recent 2004 billing data to compute the final drug add-on adjustment for 2006.

Related Links:

�Correction to the Proposed ESRD Drug Add-on Adjustment: Revised Table 22� is available at http://www.cms.hhs.gov/providers/esrd/090105_ESRD_Correction.pdf


(CMS-1502-CN) Correction notice to the Physician Fee NPRM ; Correction Notice published September 1, 2005
http://www.cms.hhs.gov/physicians/pfs/1502pcor_notice.pdf

(CMS-1502-P) Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2006; Proposed Rule published August 8, 2005
http://www.cms.hhs.gov/providerupdate/regs/cms1502P.pdf

Additional ESRD information is available at http://www.cms.hhs.gov/providers/esrd/ and http://www.cms.hhs.gov/providers/esrd.asp on the CMS website."


Thank you Mr. Venus

Sincerely,

Joe Atkins